Grant: CIHR Fellowship

Persistent vulvar pain is a prevalent and incapacitating issue that impacts up to 18% of females. The predominant subtype of vulvar pain, known as provoked vestibulodynia (PVD), manifests as a sharp pain at the vaginal entrance when pressure is applied, or vaginal penetration is attempted. Women suffering from PVD not only present with emotional distress and substantial disruption in sexual functioning, but also are confronted with limited effective therapeutic options. A potential solution to this therapeutic gap could be High-Intensity Laser Therapy, offering a non-invasive avenue for intervention. Recognized as a promising approach by experts, the recent surge in its popularity has prompted leading organizations to issue a cautionary statement urging a timely investigation into laser's effectiveness for gynecological conditions. My previous systematic review underscored the lack of studies and served as a strong basis for selecting the most optimal laser parameters. Subsequently, a randomized pilot study conducted by my team confirmed that the state-of-the-art laser treatment protocol is feasible for treating PVD, and the promising findings provided support for conducting a large-scale study. The proposed double-blind randomized controlled trial aims to establish the efficacy of High-Intensity Laser Therapy for reducing pain in women with PVD. Women will be randomized to receive either sham or active Nd:Yag laser treatment for 12 bi-weekly sessions. Validated outcome measures will be assessed at baseline, post-treatment and at 6-month follow-up. This proposal directly addresses the pressing need to determine whether women with PVD could benefit from this non-invasive treatment. It will enable women with PVD to be directed to appropriate treatment options and, if proven effective, laser could be proposed as a first-line non-invasive treatment.